Outpatient hospital services
Medicare Coverage Information
Overview
Medicare Part B covers a wide range of outpatient hospital services, including diagnostic tests, emergency room visits, lab work, and same-day surgical procedures. These services are essential for medical care that doesn't require overnight hospitalization.
- Covers diagnostic tests, lab work, and medical screenings
- Includes emergency room visits and same-day surgical procedures
- Requires medical necessity for most services
- Typically requires 20% coinsurance after meeting Part B deductible
- Services must be provided by Medicare-approved facilities
- Medicare Part B beneficiaries
- Individuals 65 and older
- Some younger individuals with qualifying disabilities
- U.S. citizens or permanent legal residents
- Part B deductible applies ($240.00 in 2024)
- Beneficiary pays 20% of Medicare-approved costs
- Medicare covers 80% of approved outpatient service costs
- Additional costs may vary based on specific services
- Services must be medically necessary
- Requires referral from healthcare provider in most cases
- Some specialized treatments may have additional restrictions
- Not all outpatient services are fully covered
- Confirm specific coverage with your Medicare plan
- Discuss medical needs with healthcare provider
- Verify Medicare approval for planned outpatient services
- Call 1-800-MEDICARE for detailed coverage information
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare outpatient serviceshospital outpatient coverageMedicare Part Bmedical treatmentsambulatory care
Related Coverage Topics
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